Individual provider Active NPI

Kevin Ruyue Kwan, MD

  • Dermatology Physician
  • Vestavia HLS, AL
National Provider Identifier
1922502764
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
50843 Issued in AL
Practice address
1940 Stonegate Dr Ste 130
Vestavia HLS, AL 35242-2541
Phone
(205) 977-9876
Fax
(205) 997-9976
NPI assigned
Mar 19, 2018
Last updated
Oct 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 50843 AL Primary

Addresses

Primary practice location

1940 Stonegate Dr Ste 130
Vestavia HLS, AL 35242-2541

Mailing address

1940 Stonegate Dr Ste 130
Vestavia HLS, AL 35242-2541
Phone (205) 977-9876

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250624000494 AL Practitioner - Dermatology 1759758873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Louisville School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqua Dermatology of Alabama PCGroup PAC ID 9436211463, 42 clinicians

Practice addresses (Care Compare)

1940 Stonegate Dr
Suite 130
Vestavia HLS, AL 35242-2541
Phone (205) 977-9876

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions526
Removal of nail tissue1-10
Removal or shaving of skin growth13
Skin biopsy317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
50843ALMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aqua Dermatology of Alabama PC Single Specialty CurrentSince Jul 1, 2025 Accepting new patients
Cutaneous Oncology & Surgery Center, LLC Past Accepting new patients

Locations

7300 Halcyon Summit Dr
Montgomery, AL 36117

1940 Stonegate Dr
Ste 130
Vestavia Hls, AL 35242
Phone (205) 451-9481

1940 Stonegate Dr
Ste 140
Vestavia Hls, AL 35242
Phone (205) 968-3919

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1922502764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 STONEGATE DR STE 130",
            "city": "VESTAVIA HLS",
            "state": "AL",
            "postal_code": "352422541",
            "telephone_number": "205-977-9876",
            "fax_number": "205-997-9976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 STONEGATE DR STE 130",
            "city": "VESTAVIA HLS",
            "state": "AL",
            "postal_code": "352422541",
            "telephone_number": "205-977-9876",
            "fax_number": "205-997-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAN",
        "first_name": "KEVIN",
        "middle_name": "RUYUE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-19",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AL",
            "license": "50843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestavia HLS, AL

Sources for this page

Verify at the official NPI Registry.